Who We Are
Overview
• Founded in the US in 1991 - over 33 years
• Headquarters: New York City, with regional offices around the country
• Multilingual customer phone service and member support materials in English, Spanish, Japanese, and Korean
• Rated A- Excellent by AM Best, 2/2024
• Products:
Medical
Dental
Vision
Networks:
Life
Short Term Disability
Long Term Disability
• Dental: Aetna Dental Administrators (ADA), DenteMax and First Dental Health (FDH)
• Vision: EyeMed Insight Network
Nippon Life Benefits is a Subsidiary of Nippon Life Insurance World-Class
Financial Strength
Founded in 1889, Nippon Life is headquartered in Osaka and Tokyo, Japan* with $645 billion in assets*
Employees:
• 47,937 Sales Representatives
• 20,135 Non-Sales Main Lines of Business
• Individual & group life insurance
•
• Individual & group annuity
Nippon Life Insurance of Japan Major Subsidiaries & Affiliated Companies Insurance and Related Businesses
• TAIJU LIFE INSURANCE COMPANY LIMITED (Japan – Life insurance)
• Nippon Wealth Life Insurance Company Limited (Japan – Life insurance)
• HANASAKU LIFE INSURANCE Co., Ld. (Japan – Life insurance)
• Nippon Life Insurance Company of America (USA – Employee benefits)
• MLC Limited (Australia – Life insurance)
• Great Wall Changsheng Life Insurance Co., Ltd. (China – Life insurance)
• Bangkok Life Assurance Public Company Limited (Thailand–Life insurance)
• Reliance Nippon Life Insurance Company Limited (India– Life insurance)
• PT Asuransi Jiwa Sequis Life (Indonesia – Life insurance)
• Grand Guardian Nippon Life Insurance Company Limited (Myanmar– Life insurance)
Asset Management-Related Businesses
• Nissay Asset Management Corporation (Japan – Investment management, investment advisory, and type II financial instruments services)
• Nippon Life India Asset Management Limited (IndiaInvestment advisory and discretionary investment contract services)
• The TCW Group, Inc. (USA – Investment advisory and discretionary investment contract services)
• Post Advisory Group, LLC (USA – Investment advisory and discretionary investment contract services)
• The Master Trust Bank of Japan, Ltd. (Japan – Trust banking services)
• Nippon Life Global Investors Americas, Inc. (USA – Loans and investment on behalf of Nippon Life)
Medical Plan Networks
National PPO Networks
• Aetna Signature Administrators ® (ASA)
• ASA is a national PPO network with more than one million participating physicians and approximately 6,400 hospitals.
• It is one of the country’s most comprehensive PPO network and holds NCQA accreditation
Private Healthcare Systems (PHCS)
• PHCS is one of the largest PPO networks, with over one million providers and 4,700 hospitals
• It provides nationwide access to providers and facilities and holds NCQA and URAC accreditation
Medical Plan Options
• PPO Plans: offer a variety of deductible, coinsurance, copays, and out-of-pocket options so you can customize a benefit solution to meet your needs.
• PPO Value Plans: similar to our Evolution PPO Plans with higher out-of-network limits to encourage in-network usage.
• High-Deductible Health Plans (HDHP): high-quality, cost-effective coverage, meant to save premium dollars, promote health advocacy.
• HDHP Value Plans: similar to our Evolution HDHP Plans but include higher out-of-network limits to encourage innetwork usage - drives down premium even further.
• Qualified HDHP plans: can be paired with an HSA (Health Savings Account).
Healthcare Accounts
Save on taxes and pay for qualified expenses.
• FSA (Flexible Spending Account) - Employer and/or Employee funded account to reimburse employees for qualified expenses
• HRA (Health Reimbursement Arrangement)Employer funded plan that can be used to reimburse a portion of Employees’ out-of-pocket medical expenses
• HSA (Health Savings Account) - A tax-advantaged personal account to pay for qualified expenses when paired with a compatible HDHP plan
Global Coverage with Aetna International
Scope of Coverage
• Medical and prescription coverage while traveling outside the U.S.
• Extends from routine check-ups to emergency treatments
• Members can visit any provider without requiring referrals
• Access to 165,000 providers outside the U.S.
• Coinsurance, deductibles, and out-of-pocket cost sharing are the same as the in-network cost-sharing within the U.S. plan benefits.
• 24/7 member service in 240 languages
Traditional East Asian Medicine
Benefit Enhancement
• Provides additional coverage for a variety of services such as acupressure and herbal supplements.
Sample of covered services
• Acupuncture
• Acupressure
• Hypnotherapy
• Massage Therapy
• Cupping
• Tai Chai
Sample of covered supplements
• Ginseng
• Fucoidan
• White Flower Oil
• Tiger Balm
Lab Testing – QuestSelect - Advanced and Plus
Outpatient lab work through Quest Diagnostics®, accredited and certified for most diagnostic tests.
For PPO members:
• Option to have covered outpatient lab testing performed at no cost Provider collection and handling fees may not be fully covered
• We pay the full amount of covered and approved lab services
• No deductibles, copays, or coinsurance costs
For HDHP members:
• Deeply discounted testing.
Tests Include:
• Blood, cholesterol, and urine tests
• Pap smears.
• Biopsies
• Cultures
• Other cytological and pathological tests
Prescription Drugs
• Prescription drug benefits are provided through CVS Caremark, the largest provider of prescriptions in the country
• More than 68,000 participating pharmacies nationwide (both CVS and non-CVS pharmacies)
• CVS Caremark Prescription Mail Service pharmacy for home delivery
• Specialty Pharmacy Services for the treatment of rare or complex conditions
• Discount program for high-cost injectable drugs
• Fast Start / Phone Option
• Order Form Option / Mail with 90 Day Script
• Auto Refill Option / Maintenance Medications
Active & Fit Direct®
• Access to 8,100+ online workout videos for home or on-the-go exercise
• Low one-time enrollment and a monthly fee
• 17,500+ standard fitness centers
• Unlimited one-on-one personalized lifestyle coaching via phone in fitness, nutrition, stress, and sleep
• No long-term contract
• Just $28 a month*
Prenatal Program
• Helping parents give babies a healthy start
• Designed to promote the health and wellbeing of babies and soon-to-be moms to help prevent health issues during pregnancy
• No cost to members
• $100 reward to participants who enroll during the first 20 weeks of pregnancy
• Call to enroll: #1-833-462-0090
• Provides 24/7 access to a national network of U.S. board-certified physicians for non-emergency medical issues or mental health visits via phone or online video
• Oldest and largest telemedicine company in U.S.
• Services all 50 states*
• Meet via phone or video chat with board-certified, state-licensed physicians for non-emergency issues
• Available for all members who request medical coverage
• PPO-No Cost for regular and MH Teledoc visits
• HDHP-Standard Visits: $55
MH cost: Psychiatrist Initial Visit: $220
Psychiatrist Ongoing Visits: $100
Psychologist, Counselor, or Therapist Visits: $90
Care Management
Aetna Active Health/Suite of Medical Management Solutions
• Pre-admission Authorization
• Large Case Management
• Utilization Management
Care Management
• Pre-admission certification
• Discharge planning
• Concurrent hospital review
• Retrospective hospital review
• Large Case Management identification and implementation
• Alternative care intervention
Organ Transplant
We work with two nationally recognized networks:
• Aetna’s Institutes of Excellence (Members in Aetna Signature AdministratorsTM)
• OptumHealth (Members in PHCS)
Wellness Services (Powered by ActiveHealth)
Core Package is included in the Medical plan at no additional cost.
CareEngine: Spots care gaps or errors and suggests improvements for members and providers
• CareEngine: Recommends screenings, tests, or treatments and warns about potential drug interactions
Wellness Portal: Provides online health assessment, personal health records, and extensive health education and resources.
• Easy access through Nippon Life Benefits’ member site and Mobile App (log-in required)
• All members aged 18 and older have their own access to the portal
• Dependents under 18 are included in the employee’s portal
Additional Buy-Up Programs
Employee Assistance Program through Telus ($1.15/employee)
• 24/7 best-in-class counseling
• Immediate telephone support from specialized professionals in counseling, social work, psychology or human services
• Virtual counseling: Video, Telephonic & SMS/Text.
• Immediate access to an EAP counselor through video and phone for confidential and secure virtual sessions
• Face-to-face, in-person, counseling
• Referrals to the LifeWorks extensive network of master’s level clinical counselors and affiliates
Additional Buy-Up Programs
Wellness Buy-Up Packages (Core package included with medical plans)
• Buy-up Package A: Core + Online Rewards Center, Incentive Report
• Buy-up Package B: Core + A + Biometrics Screening
• Buy-up Package C: Core + A + B + Telephonic Lifestyle Coaching
Wellness Portal
• Easy-to-use tips, tools, and trackers
• Simple dashboards to track progress.
• Action items, reminders, health assessments, and more
Wellness Portal
CareEngine Online Rewards Center
Biometric Screening
Telephonic Lifestyle Coaching
with Plan purchase)
Underwriting Guidelines – Large Group
Request for Proposal Requirements
Eligible Groups
Eligible Employees
Policy Situs
Availability
Minimum Number of Hours
Effective Dates
Rate Guarantee
Available Plan
Designs
Eligible groups are corporations and partnerships where there is a clear employee/employer relationship.
Eligible employees must be full-time, typically working 30 hours per week as per state laws. Certain owners and officers qualify if full-time.
Part-time, temporary, and seasonal workers are not eligible.
New York, New Jersey, Pennsylvania, South Carolina, Texas, California, Georgia, Illinois, Indiana, Michigan, Ohio, Kentucky, Tennessee and Wisconsin. Trust products are not available in all states. We cannot offer medical coverage to employees residing in Hawaii and New Hampshire.
The definition of a full-time employee must comply with the requirements of each states. Generally, where allowed by law, a minimum of 30 hours is required.
The effective date can be the 1st of the month or the 15th of the month. Groups with 15th of the month will have a 12½ policy period for the first year.
Initial rate guarantee period is 12 months.
NLB offers an assortment of Evolution PPO plans, Value PPO plans, Evolution CDHP plans, and CDHP Value plans.*
• Company name, mailing address, zip code and phone number
• Proposed effective date
• SIC code or nature of business
Information
Needed for a Quote
• Census should include all eligible employees, gender, date of birth, zip code, coverage tier, plan election, and waiver information – why they waived coverage (spousal, parental, Medicare, Medicaid). For Trust business, the census must include residential status (Expats, Green Cardholder, US Citizen), and a link to the foreign parent must be provided.
• Current and renewal rates – copy of the renewal package if available
• Name of the current insurance carrier and how the case is rated.
• Number of years with the current carrier
• Current plan design(s), plus any additional options you would like added to the proposal.
• Employer contribution percentage towards employee’s medical cost for all medical plans
• Reason why the case is out to bid.
• Experience if available or required by state (claims, premium, number of lives, and individual large claims) two years broken out by month if possible. Experience is required for groups with more than 225 enrolled or 300 eligible. If not available, please explain.
• Kaiser wrap, 40% of the eligible enrolled
*Medical
NLB Global: Medical, Vision and Ningen Dock
We excel at navigating employee benefits for foreign owned companies because we are one.
Underwriting
Guidelines for NLB Global Medical Programs and Participation Requirements -Trust
Foreign-Owned Medical Benefit
• NLB Global offers services to affiliated companies with 100+ employees worldwide*, primarily for global staff and Green Cardholders. This plan benefits employees and their families on assignment in the U.S
• If the group qualifies for our Global Trust after Underwriting review, they will receive our trust rate
• Customize your plan based on global staff’s local needs and global benefits balance
For qualifying cases, an employer may receive an additional discount based on the renewal increase and responses to the questions below.**
1. Is this group Small Group or Large Group rated?
Target Market Scorecard (TMS)
2. Is the case foreign-owned? If so, please provide us with the link to the foreign parent company.
3. Employer contribution toward the employee’s medical cost on all medical plans
4. Number of years with current carrier
5. Number of COBRA employees
Qualifications and Underwriting Guidelines
Policies must be sitused in:
global trust only
• Company must be owned by a foreign parent*
• The company must be a member of a controlled group of a foreign parent company (for example, a parent company owns at least 80% of the stock)
• The total number of employees among the affiliated companies (including the parent company) must exceed 100 worldwide
• Additional discounts may be available for groups meeting criteria based on underwriting review
®
We excel at navigating employee benefits for foreign-owned companies because we are one.
NLB Global provides medical coverage for employer groups that operate within the United States but are controlled by a foreign company or parent.
Networks
PPO options for regional, national, and global coverage with Aetna Signature Administrators®, Aetna International, PHCS, and more
Options
200 plan options to choose from for the right fit
Customer Service and Member Materials
Available in English, Spanish, Japanese, and Korean
Additional Features
• Teladoc® • Vision • Pregnancy Support Program
• Wellness Program • Hearing Aids
Active & Fit Direct
• Quest Select Advanced/ Quest Select Plus® • Nippon Life Benefits Mobile App
Employers can also select to purchase or fund additional programs such as:
• Employee Assistance Program • Life
• Healthcare Accounts • Disability
• Dental Employees who qualify for medical coverage also get access to the following:
